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Monday, December 10, 2012

ObamaCare - The Affordable Care Act and Dentistry

Six months ago, I wrote on the topic of ObamaCare and its effect on dentistry.

A lot has changed in the past six months. The United States Supreme Court ruled the law constitutional, while it allowed the states flexibility on Medicaid. President Obama was re-elected with the Democratic Party continuing their control of the United States Senate. The Republican Party continues to control the majority in the House of Representatives.

When the Affordable Care Act (ACA) passed in 2010, no one involved in oral health felt satisfied. But many cheered for what they thought would be its biggest effect on oral health: extending dental benefits to nearly all the children in the country. Two years later, serious questions have arisen about that expectation. The law is so complicated that the longer experts have spent digesting it, the more possible interpretations and unintended consequences they have found.

My best guess is that nothing will be immediate since many states have financial problems and unlike the federal government are required to balance their budgets. Expanding dental care to more Americans who cannot afford the insurance premiums will not be an easy task.

Also, Medicaid expansion, even for children, will not be cheap and who will pay for the care? Also, who will deliver the care at Medicaid fees that do not reflect the market rate of payment to providers?

Stay tuned as ObamaCare is implemented piece by piece starting in January.